Risk Assessments with the Pill

Featuring Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP

Duration: 2 minutes, 45 seconds

When we talk about risk on birth control pills we refer to the issue of having a risk assessment with your family doctor, your primary care practitioner, that’s really a visit for you to discuss your personal risk.

We understand World Health Organization guidelines around risk. And it’s important for your doctor to know whether or not you’ve had any of these concerns, whether you’ve had a migraine with neurologic deficit, whether there’s something in your family history that is very significant for risk.

We know that some risks are straightforward, for example, smoking. If you’re under 35 the World Health Organization says it’s a relative risk if you’re smoking more than 15 cigarettes per day, but if you’re over 35 it’s an absolute contraindication.

We know that age has an impact because in general older women over the age of 35 to 40 are more likely to have blood clots in the general population than younger women. So when we put a n 18-year-old on the birth control pill she just by age alone is less at risk than a 40-year-old.

We know that BMI or your weight has an impact on risk of blood clots. The heavier you are the greater your risk. When we’re looking and doing a risk assessment as primary care practitioners we’re also looking at your family history.

If there’s a family history of blood clots it may be that your family carries a certain abnormality in the blood that makes you more at risk for blood clots. So when we talk about a risk assessment it’s you having that discussion with your primary care provider about personal risk.

Your age, your BMI, whether you smoke or not, whether or not you are risk because of other underlying issues in your personal health or in your family health. Birth control pills are extremely safe and side effects and risk is rare but we want to select those people who are more at risk and give them opportunities to choose other options so that we see less risk on birth control pills as time goes on.

The most important feature about a risk assessment is you. You’re making a good decision to see your primary care practitioner, your family doctor, you’re making a responsible decision to do something about contraindications, you’re making a risk assessment for yourself so that you can feel comfortable about what you’re choosing to do with your life.

Presenter: Dr. Vivien Brown, Family Doctor, Toronto, ON

Local Practitioners: Family Doctor